title: A randomized controlled trial of cognitive behavioral group therapy for bipolar disorder.
abstract: BACKGROUND
  This study evaluated the effectiveness of adjunctive cognitive behavioral group therapy (CBGT) to prevent recurrence of episodes in euthymic patients with bipolar disorder.
  
  
  METHODS
  A randomized controlled single-blind trial was conducted with 50 patients with bipolar disorder types I and II followed up for at least 12 months in an outpatient service and whose disease was in remission. An experimental CBGT manual was developed and added to treatment as usual (TAU), and results were compared with TAU alone.
  
  
  RESULTS
  Intention-to-treat analysis showed that there was no difference between groups in terms of time until any relapse (Wilcoxon = 0.667; p = 0.414). When considering type of relapse, there was still no difference in either depressive (Wilcoxon = 3.328; p = 0.068) or manic episodes (Wilcoxon = 1.498; p = 0.221). Although occurrence of episodes also did not differ between groups (χ(2) = 0.28; p = 0.59), median time to relapse was longer for patients treated with CBGT compared to TAU (Mann-Whitney = -2.554; p = 0.011).
  
  
  CONCLUSIONS
  Time to recurrence and number of episodes were not different in the group of patients treated with CBGT. However, median time to relapse was shorter in the TAU group. Studies with larger samples may help to clarify whether our CBGT approach prevents new episodes of bipolar disorder. Our findings also indicated that CBGT is feasible in euthymic patients with bipolar disorder and should be investigated in future studies. To our knowledge, this is the first publication of a controlled trial of CBGT for euthymic patients with bipolar disorder.
authors.affiliation: Bipolar Disorders Research Program, Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil. bernardocarramao@gmail.com
authors.forename: B C
authors.initials: BC
authors.lastname: Gomes
authors.forename: L N
authors.initials: LN
authors.lastname: Abreu
authors.forename: E
authors.initials: E
authors.lastname: Brietzke
authors.forename: S C
authors.initials: SC
authors.lastname: Caetano
authors.forename: A
authors.initials: A
authors.lastname: Kleinman
authors.forename: F G
authors.initials: FG
authors.lastname: Nery
authors.forename: B
authors.initials: B
authors.lastname: Lafer
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000628:therapy*; D001938:Brazil; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult